子宫内膜癌ProMisE分子分型与淋巴结转移及其他临床特征的关系  

The Relationship between ProMisE Molecular Typing and Lymph Node Metastasis and Other Clinical Features in Endometrial Cancer

作　　者：李园园[1] 李倩[1] 何莲 朱延美 张新[1] LI Yuan-yuan;LI Qian;HE Lian;ZHU Yan-mei;ZHANG Xin(Department of Gynecology,Cancer Hospital Affiliated of Dalian University of Technology/Liaoning Cancer Hospital and Institute,Shenyang 110042,China;Department of Pathology,Cancer Hospital Affiliated of Dalian University of Technology/Liaoning Cancer Hospital and Institute,Shenyang 110042,China)

机构地区：[1]大连理工大学附属肿瘤医院/辽宁省肿瘤医院妇科,110042 [2]大连理工大学附属肿瘤医院/辽宁省肿瘤医院病理科,110042

出　　处：《国际妇产科学杂志》2023年第4期377-381,391,共6页Journal of International Obstetrics and Gynecology

基　　金：辽宁省科学技术基金(2019JH8/10300073);沈阳市科学技术基金(19-112-4-082)。

摘　　要：目的:探讨子宫内膜癌ProMisE分子分型与淋巴结转移及其他临床特征的相关性。方法:选取2014年12月—2018年12月于大连理工大学附属肿瘤医院行手术治疗的子宫内膜癌患者74例,收集患者的临床资料,采用ProMisE方法进行分子分型,比较不同分型患者的临床特征,并分析子宫内膜癌淋巴结转移的影响因素。结果:74例子宫内膜癌患者中错配修复缺陷型20例(27.0%),POLE突变型2例(2.7%),p53野生型34例(46.0%),p53突变型18例(24.3%)。4种分子分型患者在淋巴结转移(P=0.004)、临床分期(P=0.018)和病理分级(P=0.036)方面差异有统计学意义。二分类Logistic回归分析显示p53突变型(OR=27.669,95%CI:3.224~237.480,P=0.002)和肌层浸润≥1/2(OR=22.046,95%CI:4.185~116.146,P<0.001)是淋巴结转移的危险因素。结论:分子分型可为术前决策提供重要参考,对于术前诊断性刮宫标本的ProMisE分子分型为p53突变型的患者,淋巴结转移风险高,术中可能需要扩大手术范围。Objective:To explore the correlation between ProMisE molecular typing and lymph node metastasis and other clinical features in endometrial cancer.Methods:74 patients with endometrial cancer who underwent surgical treatment at Cancer Hospital Affiliated of Dalian University of Technology from December 2014 to December 2018 were selected.Clinical data were collected and molecular typing was performed using the ProMisE method.The clinical characteristics of patients with different subtypes were compared,and the influencing factors of lymph node metastasis in endometrial cancer were analyzed.Results:Among 74 patients with endometrial carcinoma,20 patients(27.0%)were mismatch repair defective,2 patients(2.7%)were POLE mutant,34 patients(46.0%)were p53 wild-type,and 18 patients(24.3%)were p53 mutated.There were statistically significant differences in lymph node metastasis(P=0.004),clinical stage(P=0.018),and pathological grading(P=0.036)among the four molecular subtypes of patients.Binary Logistic regression analysis revealed that p53 mutated(OR=27.669,95%CI:3.224-237.480,P=0.002)and muscle infiltration≥1/2(OR=22.046,95%CI:4.185-116.146,P<0.001)as risk factors for lymph node metastasis.Conclusions:Molecular typing can provide an important reference for preoperative decision-making,that is,ProMisE molecular typing is performed on preoperative diagnostic uterine curettage specimens.If p53 mutant is found,the risk of lymph node metastasis is high and may need to be expanded intraoperatively.

关 键 词：子宫内膜肿瘤 ProMisE分子分型 DNA错配修复 突变 基因 淋巴转移 

分 类 号：R737.33[医药卫生—肿瘤]